eMedinewS26th September 2013, Thursday

Dr K K Aggarwal Padma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04);
For updates follow at
www.facebook.com/Dr KKAggarwal

Very Low–Calorie Diet Mimics Benefits of Bariatric Surgery

Marked improvement in blood sugar control occurs in patients with type 2 diabetes mellitus shortly after Roux–en–Y gastric bypass surgery (RYGB) and before there is major weight loss.

A study determined whether the magnitude of this change is primarily due to caloric restriction or is unique to the surgical procedure.

Eleven admitted subjects who underwent RYGB and fourteen subjects mean–matched for BMI, HbA1c, and diabetes duration were given a very low–calorie diet of 500 kcal/day with a macronutrient content similar to that consumed by patients after RYGB.

Frequently sampled intravenous glucose tolerance tests were performed before and after interventions.

Both groups lost an equivalent amount of weight over a mean study period of 21 days. Insulin sensitivity, acute insulin secretion after intravenous glucose administration, and β–cell function as determined by disposition index improved to a similar extent in both groups.

Likewise, changes in fasting glucose and fructosamine levels were similar. Based on these data, VLCD improves insulin sensitivity and β–cell function just as well as RYGB in the short term. (Diabetes 2013;62(9):3027–3032)

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

VIP’s on CPR 10 Mantra Video
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

sprritual blog

1. Energy is the raw material of the universe.
2. Information is the organization of energy into reproducible patterns.
3. Consciousness is living information and energy (living energized information)
4. Consciousness is, therefore, intelligence.
5. Intelligence is information and energy that has self–referral or the ability to learn through experiences and the ability to reinterpret and influence one’s own information and energy states.
6. Consciousness is live, advanced, software–driven energized information. Nearest example: Advanced computer software which can type, correct, interpret, edit and store spoken or read information.

cardiology news

The Obstacle in Our Path

In ancient times, a King had a boulder placed on a roadway. Then he hid himself and watched to see if anyone would remove the huge rock. Some of the king’s wealthiest merchants and courtiers came by and simply walked around it. Many loudly blamed the King for not keeping the roads clear, but none did anything about getting the stone out of the way.

Then a peasant came along carrying a load of vegetables. Upon approaching the boulder, the peasant laid down his burden and tried to move the stone to the side of the road. After much pushing and straining, he finally succeeded. After the peasant picked up his load of vegetables, he noticed a purse lying in the road where the boulder had been. The purse contained many gold coins and a note from the King indicating that the gold was for the person who removed the boulder from the roadway.

The peasant learned what many of us never understand! Every obstacle presents an opportunity to improve our condition.

News Around The Globe

5th Dil Ka Darbar

Date: Sunday, 29th September 2013, Venue: Constitution club of India, Rafi Marg, Time: 8 AM to 6 PM

Programme: A non stop question answer–session between all top cardiologists of the NCR region and the public.

The focus of the discussions will be prevention of heart diseases in women and young men. Special discussion will be held on Sex and Heart Diseases. Practical training will also be given to people on Hands–only Cardiopulmonary Resuscitation. Another focus of the discussion will be the launch of the Project Dhadkan (Palpitations) and Project Murmur (Congenital and valvular heart diseases in children).

Entry free…

  • PET imaging before and after radiation therapy for inoperable, early non–small cell lung cancer (NSCLC) can pick up high– and low–risk patients, which could help inform clinical decision–making, according to a study reported at the American Society for Radiation Oncology meeting. A larger absolute change in tracer uptake after stereotactic body radiation therapy (SBRT) was associated with a reduced risk of treatment failure. A lower standardized uptake value (SUV) before treatment was associated with improved overall survival.
  • Older patients with cerebrovascular pathology had improved executive function and information processing speed if they stayed active. At 3–year follow–up in the LADIS (Leukoaraiosis And Disability) study, dementia–free older patients who lived an active lifestyle had better executive function and information processing speed than those who were not active. Kristian Frederiksen, MD, a PhD candidate at Copenhagen University Hospital in Denmark, and colleagues presented the findings at the World Congress of Neurology.
  • Levels of pro–brain natriuretic peptide (proBNP) predict cardiovascular risk in patients both with and without type 2 diabetes, regardless of the severity of coronary disease at baseline. proBNP levels were associated with a roughly 25% to 50% greater risk of having a cardiovascular event during follow–up for diabetic and non–diabetic patients. ProBNP in patients with type 2 diabetes, as well as in patients without diabetes, is useful for cardiovascular risk stratification and provides prognostic information over and above the angiographically determined coronary artery disease state, according to Christoph Saely, MD, of the Academic Teaching Hospital Feldkirch in Austria
  • The FDA has approved ustekinumab (Stelara) for the treatment moderate–to–severe psoriatic arthritis in adult patients, based on the findings of two phase III studies (PSUMMIT I and PSUMMIT II) of this fully human monoclonal antibody, which targets two cytokines, interleukin (IL)–12 and IL-23.
  • Women and girls with type 1 diabetes tend to have worse blood sugar control than men and boys. In a cross–sectional study of data from 13 countries, women and girls were significantly more likely to have an HbA1c of 9% or higher than men with the condition. Women tend to have lower levels of hemoglobin than men, which "could explain the higher HbA1c levels, but further research is required to confirm this, said Sarah Wild, PhD, of the University of Edinburgh in Scotland at the European Association for the Study of Diabetes meeting

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Rabies News (Dr. A K Gupta)

Should modern rabies vaccines meant for use in man be given to animals?

It is advisable to use human vaccines for human use and use the veterinary vaccines for animals.

cardiology news
  • A biomarker of acute kidney injury was predictive of worse outcomes at 3 months in one ischemic stroke model, but not in another. Plasma concentrations of the protein neutrophil gelatinase–associated lipocalin (NGAL) at 1 week were associated with worse outcomes when added to a model assessing NIH stroke score, age, thrombolysis, and estimated glomerular filtration rate (eGFR). However in a model that included post–stroke infection, concentrations of NGAL offered no predictive value in patient outcomes. The findings of the study were presented at the World Congress of Neurology.
  • Galectin–3 (Gal–3), a biomarker for fibrosis, may have a role in identifying heart failure caused by cardiac amyloidosis. Levels of Gal–3 were significantly more elevated in patients with cardiac amyloidosis compared to those with left ventricular (LV) hypertrophy (P<0.050) and those with systolic heart failure (P<0.05), according to Eitan A. Friedman, MD, of Vanderbilt University in Nashville, Tenn., and colleagues. Although levels of Gal–3 were elevated in the other two groups as well, researchers found no differences between those two groups in the biomarker levels, they reported here at the annual meeting of the Hart Failure Society of America.

Valvular Heart Disease News

Patient with large vegetation are at high risk of complications.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

cardiology news
  • Fetal exposure to anti–epileptic drugs (AEDs) appears to carry risks beyond those congenital defects currently listed on the products’ labels. A population–based registry study in Denmark presented at the World Congress of Neurology indicated significantly increased risks of low birth weight, preterm birth, and smaller–than–normal head circumference in infants born to mothers taking AEDs during pregnancy, said Demet Kilic, MD, of Aarhus University Hospital in Aarhus, Denmark.
  • First–time mothers who expressed concerns about breast–feeding their new baby 3 days postpartum were 9 times more likely to stop breast–feeding by 60 days postpartum than mothers who reported no concerns in a new study. The study was published online September 23 in Pediatrics. (Source: Medscape)
cardiology news

Smell check, scratch and sniff, a new test for Parkinson’s disease

Olfactory dysfunction presenting as odor detection, discrimination, and identification is a common finding in patients with early non vascular Parkinson’s disease.

As per a study of 2,267 men published in the Annals of Neurology, an impaired sense of smell could be an early indicator of Parkinson’s disease, occurring up to four years before motor skill problems appear.

In the study decreased odor identification was associated with older age, smoking, more coffee consumption, less frequent bowel movements, lower cognitive function and excessive daytime sleepiness, but even after adjusting for these factors, those with the lowest odor identification scores had a five time greater risk of developing Parkinson’s disease than those with the highest scores.

Nerve loss and the formation of Lewy bodies — abnormal clumps of proteins inside nerve cells that are thought to be a marker of the disease — are known to take place in the olfactory structures of patients with the disease.

An impaired sense of smell could also be caused by impaired sniffing, which may be another motor symptom of Parkinson’s.

Early indicators of Parkinson’s disease are olfactory abnormality, constipation and sleep disturbances.

Besides Parkinson’s disease, obesity, diabetes, hypertension, malnutrition, Alzheimer’s disease, multiple sclerosis and Korsakoff’s psychosis are all accompanied or signaled by smell disorders.

cardiology news

Total CPR since 1st November 2012 – 63400 trained

CPR Classes 63400

Media advocacy through Print Media

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29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August


TB more dangerous than FLU 29th August


Heart disease is the most common cause of death and disability in urban women

Important differences between women and men in the presentation of heart disease make it more difficult to establish a diagnosis in women, said Padma Shri and Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India. He was addressing a press conference as a curtain raiser to the 5th Dil Ka Darbar to be held on Sunday, 29th September. The event is being organized by the Heart Care Foundation of India at Constitution Club of India in association with Ayush, Department of Health, Government of NCT Delhi, LIC, MTNL, Central Bank of India and GAIL.

Special Guests of Honour were Padma Shri & Rajiv Gandhi Khel Ratna Awardee Yogeshwar Dutt, a Bronze Medalist at the 2012 Summer Olympics in the 60 kg Freestyle wrestling, Dronacharya Awardee Yashbir Singh (Wrestling coach) and Arjuna Awardee Dharmendra Dalal, a Bronze Medalist in 120 Kg Greco-Roman style wrestling at the 2010 Commonwealth Games.

Dr KK Aggarwal said:

  1. Women generally present 10 years later than men and with greater risk factor burden.
  2. Women are less likely than men to have typical angina.
  3. Women in the emergency department with new onset of chest pain are approached and diagnosed less aggressively than man.
  4. Women are more likely to present initially with chest pain than a more clearly defined event such as heart attack.
  5. Symptoms of heart attack in women differ from those in men.
  6. Many cases of heart attack in women are unrecognized.
  7. In women, treadmill exercise has a higher false positive rate.
  8. Small vessel disease is more common in women than in men.
  9. Established risk factors in women are: Presence of history of heart blockages; age over 55 years; high LDL (bad) or low HDL (good) cholesterol, diabetes, smoking, high blood pressure, peripheral artery disease or family history of heart disease.
  10. Risk factors, which are more potent in women than in men are: Smoking is associated with 50% of all coronary events in women; diabetes confers more prognostic information in women than in men.

Prevention in Women

For all Women

  • Moderate intensity physical activity for at least 30 minutes and for 60 to 90 minutes for weight management on most days of the week.
  • Avoidance and cessation of cigarette smoking and passive smoking
  • Keep waist circumference less than 35 inches.
  • Take a heart-friendly diet.
  • Presence of high triglyceride levels. One should add Omega 3 fatty acids to diet.
  • Control cholesterol level, high blood pressure and diabetes.
  • Women who smoke should avoid oral contraceptive pills.
  • Aspirin 80 mg in more than 65 years of age should be added
  • Treat underlying depression.

Women at high risk

  • Aspirin 75 to 150 mg, as prevention
  • Control of blood pressure.
  • No use of antioxidant vitamin supplement.
  • No use of folic acid support.
  • No Hormone Replacement Therapy.
  • Lowering of LDL cholesterol of less than 80.

Co-addressing the Press Conference, Mr GP Sinha GM (Mktg) MTNL said that the best gift we can give to our wives, mothers and sisters is an annual heart check up. Dr NK Yadav, MHO, South Delhi, Medical Corporation; Dr. PK Sharm, MOH, NDMC; Dr NV Kamat, Director, Health Services, Delhi; and Sr representatives from Central Bank of India in a joint statement said that our concern in women should shift from breast cancer to heart awareness as the lifestyle adopted to prevent heart disease would also prevent breast cancer.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on" Hands only CPR" of 63400 people since 1st November 2012.

The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

today emedipics

Padma Shri and Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India addressing a press conference as a curtain raiser to the 5th Dil Ka Darbar to be held on Sunday, 29th September. The event is being organized by the Heart Care Foundation of India at Constitution Club of India.

press release

Dr KK Aggarwal Speaks on Key points on CKD

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

The pain management nurse assesses a 67–year–old patient for reports of episodic, sudden–onset, and right–sided facial pain. The patient describes the pain as fleeting, electric-like, and triggered by light touch and brushing of the teeth. The pain management nurse suspects:

a. facet syndrome.
b. myofascial pain syndrome.
c. temporomandibular disorder.
d. trigeminal neuralgia.

Yesterday’s Mind Teaser: Biofeedback is a therapy used to:

a) Develop psycho–physiologic self–regulation.
b) Enhance drug delivery.
c) Increase release of serotonin.
d) Promote neuronal regeneration.

Answer for yesterday’s Mind Teaser: Develop psycho–physiologic self–regulation.

Correct answers received from: Dr Ajay Gandhi, Dr. V.P. Thakral, Dr.K.V.Sarma, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr.Bitaan Sen & Dr.Jayashree Sen, Muthumperumal Thirumalpillai, Daivadheenam Jella, Dr Chandresh Jardosh, Dr Avtar Krishan, Dr Kanta Jain, Dr B K Agarwal, Dr. P. C. Das, Dr Kanta Jain, Sushma Chawla.

Answer for 23rd September Mind Teaser: Morning fatigue, widespread body pain, and focal tenderness.

Correct answers received from: Daivadheenam Jella, Dr Chandresh Jardosh.

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

Tech support: How may I help you?
Customer: I’m writing my first e–mail.
Tech support: OK, and what seems to be the problem?
Customer: Well, I have the letter ‘a’ in the address, but how do I get the circle around it?

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient after sublingual nitrate developed fainting attack.
Reaction: Oh my God! Why was the systolic murmur missed on auscultation?
Lesson: Make sure that patient with left ventricular outflow tract (LVOT) obstruction are not given sublingual nitrates.

medicolegal update

Problems are only opportunities in work clothes. Henry J. Kaiser

medicolegal update

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: Empirical facts are not descriptions of fundamental reality but descriptions of modes of human observation using a human nervous system

medicolegal update

Dear Editor, Since no direct link between statins and cataract has been established, the usefulness of statins in effectively lowering cholesterol (and, thus, reducing the risk of cardiovascular disease) outweighs the risk of developing cataract, that can easily be treated surgically. Dr. Narendra Kumar Ophthacare Eye Centre

Forthcoming Events

29thSeptember–Dil Ka Darbar at Constitution Club of India, New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update

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